寰枢椎脱位术前可复性评价的意义应被重新审视

The significance of preoperative evaluation for atlantoaxial reducibility should be reevaluated

在寰枢椎脱位的治疗中,可复性评价曾是其分型的主要依据。近年来,随着寰枢椎后路手术技术的发展,寰枢椎脱位的治疗范式正由前后联合入路逐渐向单纯后路复位转变。通过后路关节间松解、撑开,可使一部分在传统理念上不可复的寰枢椎脱位变为可复,加之随着基于后路复位手术新分型的提出,寰枢椎脱位术前可复性评价的意义和必要性也应该重新被审视。笔者依据本中心在寰枢椎脱位领域多年来的临床经验,就目前该疾病手术治疗中的热点问题提出自己的观点,供同行参考和批评指正。

For treatment of atlantoaxial dislocation,the evaluation of reducibility used to be the main basis for its classification.In recent years,with the development of posterior reduction techniques,the treatment paradigm for atlantoaxial dislocation is gradually changing from a combined anterior and posterior approach to a direct posterior approach.Through posterior intra-articular release and distraction,part of atlantoaxial dislocation which is irreducible in traditional concept can become reducible.With the new proposed strategy based on posterior reduction techniques,the significance and necessity of preoperative evaluation for atlantoaxial reducibility should be reevaluated.Based on our clinical experience,we put forward our views on this hot topic for peer reference and criticism.